Mills Lynnea M, Cate Olle Ten, Boscardin Christy, O'Sullivan Patricia S
University of California, San Francisco, US.
University Medical Center Utrecht, NL.
Perspect Med Educ. 2024 Dec 27;13(1):684-692. doi: 10.5334/pme.1521. eCollection 2024.
When health professions learners do not meet standards on assessments, educators need to share this information with the learners and determine next steps to improve their performance. Those conversations can be difficult, and educators may lack confidence or skill in holding them. For clinician-educators with experience sharing challenging news with patients, using an analogy from clinical settings may help with these conversations in the education context. One common model in the clinical setting for 'breaking bad news' to patients is SPIKES: Set-up, Perception, Invitation, Knowledge, Emotion, and Summary/Strategy. The authors reviewed evidence in the education setting, particularly from the remediation literature, to consider how the SPIKES model might translate from clinical settings to those in which educators must share 'bad news' with learners about their academic performance. Based on available guidelines and evidence, the authors advocate that the SPIKES model can serve as a useful framework to help educators incorporate, by way of analogy, key components into these conversations, and increase the likelihood of successful outcomes.
当卫生专业学习者在评估中未达标准时，教育工作者需要将此信息告知学习者，并确定提高其表现的后续步骤。这些对话可能会很困难，教育工作者在进行此类对话时可能缺乏信心或技巧。对于有向患者传达具有挑战性消息经验的临床教育工作者而言，运用临床场景中的类比可能有助于在教育环境中进行这些对话。临床环境中向患者“告知坏消息”的一种常见模式是SPIKES：设定、感知、邀请、知识、情绪和总结/策略。作者回顾了教育环境中的证据，特别是来自补救文献的证据，以思考SPIKES模式如何从临床环境转化到教育工作者必须就学习者学业表现向其传达“坏消息”的环境中。基于现有指南和证据，作者主张SPIKES模式可作为一个有用的框架，通过类比帮助教育工作者将关键要素纳入这些对话，并增加取得成功结果的可能性。
